Aleukemic leukemia cutis: Juvenile chronic granulocytic leukemia presenting with figurate cutaneous lesions

Heskel, Neil S.; White, Clifton R.; Fryberger, Sarah; Neerhout, Robert C.; Spraker, Mary K.; Hanifin, Jon M.

doi:10.1016/s0190-9622(83)70153-2

Cited by 20 publications

(15 citation statements)

References 7 publications

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“…Leukemic skin infiltration tends to be indurated erythema and often appears on acral regions, including the hands, feet, and ears (10). It is very interesting that eruptions due to skin infiltration preceded any other manifestation in the three cases reported by Heskel (7), Buescher (8), and Sires (9).…”

Section: Discussionmentioning

confidence: 84%

“…To our best knowledge, there have been only seven reported cases of JMML with skin infiltration of leukemic cells (6–11). In these cases, skin eruptions have been described as erythematous maculopapular lesions on the legs (6), erythematous indurated circular areas with central clearing on the abdominal wall and eczematous papular eruption on the trunk and arms (6), figurate, red, urticarial lesions on the trunk and arms (7), many annular erythematous lesions, measureing 2 to 3 cm predominantly on the legs and buttocks (8), annular, erythematous, circinate plaques on the trunk and extremities (9), and indurated erythema on the auricles and the extremities (10). One case was revealed to be skin infiltration by postmortem examination (11).…”

Section: Discussionmentioning

confidence: 99%

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Skin Infiltration of Juvenile Myelomonocytic Leukemia

Matsumoto

Miki

Matsuzaki

et al. 2004

The Journal of Dermatology

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We described a two-year-old boy who developed a skin infiltration from JMML. Several indurated erythematous lesions were seen on his back on his first visit to our department. Edematous erythemas had repeatedly appeared on his auricles and feet for the previous six months. He had had a high fever for a month. Hepatosplenomegaly and superficial lymphadenopathy were recognized. Laboratory investigation showed leukocytosis and anemia. The diagnosis of JMML was confirmed by the findings of myeloid hyperplasia in his bone marrow and the spontaneous colony formation and GM-CSF hypersensitivity in a culture of bone marrow cells. Histopathologically, large atypical mononuclear cells were infiltrated throughout the dermis in a perivascular and interstitial distribution in a skin biopsy specimen. These cells were CD3 (-), CD20 (-), CD45 (+), CD68 (+) and myeloperoxidase (+). Bone marrow transplantation and then cord blood stem cell transplantation were performed but soon rejected. The indurated erythematous lesions appeared again soon after the relapse of JMML. There are other reported cases of JMML with skin infiltration that preceded any other manifestations of the disease. JMML cells in some patients, including our case, seem to have a great affinity for the skin, and skin biopsy aids in early detection of this disease.

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Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Skin Infiltration of Juvenile Myelomonocytic Leukemia

Matsumoto

Miki

Matsuzaki

et al. 2004

The Journal of Dermatology

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“…Although less common, LC can also be present in patients with lymphoblastic leukemias, with an estimated incidence in 1.3% of patients. 1,7,8,[10][11][12][13][14][15]17,21,25,[32][33][34][35][36][37][38][39] Though most commonly associated with myeloid leukemias, ALC can also be seen in association with pre-B-cell ALL 9,17,20 and in rare cases of T-cell ALL. 2,3,29 Interestingly, Longacre et al 30 reviewed 123 skin biopsies of leukemic patients who had no clinical skin findings and found LC in 30% of cases.…”

Section: Discussionmentioning

confidence: 99%

“…1 However, LC has also been described in association with chronic myelogenous leukemia, myelodysplastic syndromes (MDS), and acute lymphoblastic leukemias (T-ALL and B-ALL). [6][7][8] Rarely, cutaneous involvement by a leukemic infiltrate can occur in the absence of bone marrow or peripheral blood involvement by acute leukemia; this then is referred to as aleukemic LC (ALC) [9][10][11][12][13][14][15][16][17] or aleukemic myeloid sarcoma. Myeloid sarcoma, extramedullary myeloid tumor, granulocytic sarcoma, and monocytic sarcoma are often termed LC when occurring in the skin.…”

Section: Introductionmentioning

confidence: 99%

Pediatric Aleukemic Leukemia Cutis

Gru

Coughlin

Schapiro

et al. 2015

The American Journal of Dermatopathology

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Leukemia cutis (LC) denotes a cutaneous infiltration of neoplastic myeloid cells or lymphoid blasts, which can present in the setting of acute myeloid leukemia, particularly in those cases with monocytic or myelomonocytic differentiation. Rarely, cutaneous involvement by a leukemic infiltrate can occur in the absence of bone marrow or peripheral blood involvement by acute leukemia; this then is referred to as aleukemic LC (ALC). Recognition of LC is important for further classification and early diagnosis of the disease, but the diagnosis is difficult in the absence of a systemic presentation of acute leukemia. Although the molecular and cytogenetic features of ALC are poorly characterized, some have shown specific molecular alterations in common with classic forms of acute leukemias. We present 3 cases of ALC in pediatric patients.

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“…It is more common in males than in females. In recent years, several series of JXG have been reported.11 M Although cafe au lait spots were noted in eight of 45 patients in one study,13 in none of these series was there a recognition of the asso¬ ciation with documented NF.…”

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confidence: 97%